In recent years, a number of developments have occurred in the world of celiac disease (CeD): the role of genetic and environmental factors involved in the pathogenesis has been better elucidated, new information on the fate of the “potential” celiac children has been generated, new diagnostic and follow-up guidelines have been created, and new exciting prospects have been opened in the possibility of alternative treatments. This review will cite recent relevant publications, presenting in a concise format their most meaningful contributions.
Purpose of Review
With the constantly changing presentation of celiac disease, the practicing physician is challenged with the task of discerning which patients need to be assessed in the most cost conscious way possible. This review aims at providing an updated, critical reassessment of celiac disease and how to accomplish this goal.
Environmental factors responsible for the ever-increasing prevalence of celiac disease do not appear to include infant feeding modalities as thought for many years, but rather now include infections, with a special role for viral infections, and use of antibiotics in early life. Given the invasive nature of endoscopy in the diagnosis of CeD, algorithms have been created to limit the need for endoscopy with biopsy in select patients. Celiac patients with straightforward symptoms and appropriate resolution of symptoms should not require repeat endoscopies to confirm mucosal healing. Celiac children respond much faster and more completely to the gluten-free diet than their adult counterparts. While a gluten-free diet remains the only current treatment option for CeD, many new and exciting pharmacological agents are on the horizon
Advanced knowledge of possible environmental factors that may lead to the onset of CeD. The correct approach to working up and treating a patient with CeD. Emerging therapy options for patients with CeD.
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Jericho, H., Guandalini, S. Celiac Disease. Curr Pediatr Rep 6, 40–49 (2018). https://doi.org/10.1007/s40124-018-0154-y